Diagnosis
Head and neck cancer diagnosis often begins with an exam of the head and neck area. Other tests might include imaging tests and a procedure to remove some cells for testing. The tests used for diagnosis may depend on the cancer's location. Head and neck cancers include cancers that start in the mouth, throat, sinuses and salivary glands.
Examining the head and neck area
A healthcare professional may look at your head and neck area for sores or other issues. The health professional might feel your neck for lumps or swelling. To see inside your mouth, the health professional might use a light and a mirror. To see inside the throat, sometimes a tiny camera is put down the throat. The camera transmits images that let the health professional look for signs of cancer. To see inside the nose, a tiny camera can go through the nostrils.
Imaging tests
Imaging tests make pictures of the inside of the body. The pictures can show the size and location of the cancer. Imaging tests used for head and neck cancer include CT, MRI and positron emission tomography scans, also called PET scans.
Removing a sample of tissue for testing
A biopsy is a procedure to remove a sample of tissue for testing in a lab. How the cells are collected depends on the cancer's location. If the cancer is easy to access, a healthcare professional might cut out some of the tissue with a cutting tool. Sometimes a needle can go through the skin and into the cancer to draw out some cells. Special tools can collect cells from inside the throat or inside the nose.
Testing the tissue sample in the lab
The tissue sample collected during a biopsy goes to a lab for testing. Tests can show if the cells are cancerous. Other special tests give more details about the cancer cells. For instance, the cells might be tested for signs of HPV infection. Your healthcare team uses this information to make a treatment plan.
Treatment
Head and neck cancer treatment often involves surgery to remove the cancer. Other treatments might include radiation therapy, chemotherapy and other medicines. Treatment may depend on the location of the cancer. Head and neck cancers include cancers that start in the mouth, throat, sinuses and salivary glands.
Surgery
When possible, surgeons use cutting tools to cut out all of the cancer. They also take a small amount of the healthy tissue around the cancer. This margin of healthy tissue helps ensure that all the cancer cells are removed.
Sometimes the cancer grows into nearby structures and can't be removed. Treatment might start with other options instead, such as radiation therapy and chemotherapy.
Some operations for head and neck cancer can affect your ability to eat and speak. Your healthcare team works to minimize this risk. Reconstructive surgery can help replace bones and tissue that are removed during an operation. Rehabilitation specialists can help you regain the ability to eat and speak.
Radiation therapy
Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.
Radiation might be used after surgery to kill any cancer cells that are left. If surgery isn't an option, treatment might start with radiation instead.
Chemotherapy
Chemotherapy treats cancer with strong medicines. Chemotherapy is sometimes used at the same time as radiation therapy. When they are used at the same time, chemotherapy helps the radiation therapy work better. If the cancer spreads to other parts of the body, chemotherapy might be used to control the cancer.
Targeted therapy
Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. For head and neck cancer, targeted therapy may be used when the cancer spreads to other parts of the body.
Immunotherapy
Immunotherapy is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. It might be an option for head and neck cancer that spreads to other parts of the body.
Palliative care
Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. Palliative care is done by a team of healthcare professionals. This can include doctors, nurses and other specially trained professionals. Their goal is to improve the quality of life for you and your family.
Palliative care specialists work with you, your family and your care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy or radiation therapy. Ask your healthcare team if palliative care is an appropriate option for you.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Clinical trials
Clinical trials are studies of new treatments. These studies provide a chance to try the latest treatments. The risk of side effects might not be known. Ask your healthcare professional if you might be able to be in a clinical trial.
Coping and support
People facing a serious illness like cancer often say they feel scared and worried for the future. With time, you'll find ways to cope with your feelings, but you may find comfort in these strategies:
Ask questions about your cancer
Write down questions you have about your cancer. Ask these questions at your next appointment. Also ask your healthcare team for reliable sources where you can get more information. It may help to bring someone with you to your appointments to help you remember all the information you receive.
Knowing more about your cancer and your treatment options may make you more comfortable when you make decisions about your care.
Stay connected to friends and family
Your cancer diagnosis can be stressful for friends and family too. Try to keep them involved in your life.
Your friends and family will likely ask if there's anything they can do to help you. Think of tasks you might like help with, such as caring for your home if you have to stay in the hospital or just listening when you want to talk.
Find someone to talk with
Find someone you can talk with who has experience helping people facing a life-threatening illness. Ask your healthcare team to suggest a counselor or medical social worker you can talk with. For support groups, contact the American Cancer Society or ask your healthcare team about local or online groups.
Preparing for your appointment
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.
If you might have head and neck cancer, you may be referred to:
- A doctor who specializes in diseases of the face, mouth, teeth, jaws, salivary glands and neck. This doctor is called an oral and maxillofacial surgeon.
- A doctor who specializes in diseases that affect the ears, nose and throat. This doctor is called an ENT specialist. Another term for this kind of doctor is an otolaryngologist.
Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet before a test.
- Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including major stresses or recent life changes.
- Make a list of all medicines, vitamins or supplements you're taking and the doses.
- Take a family member or friend along. Sometimes it can be hard to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
- Write down questions to ask your healthcare team.
Your time with your healthcare team is limited, so prepare a list of questions to help you make the most of your time together. List the three most important questions first so you can be sure to ask them before time runs out. List the rest of your questions from most important to least important. Some basic questions to ask include:
- What kind of cancer do I have?
- What other tests do I need?
- What are my treatment options?
- What might happen if I decide that I don't want treatment?
- Is there one treatment that's best for my type and stage of cancer?
- What are the potential side effects of each treatment?
- Should I seek a second opinion? Can you give me the names of specialists you recommend?
- Am I eligible for clinical trials?
- Are there brochures or other printed material that I can take with me? What websites do you recommend?
- What will determine whether I should plan for a follow-up visit?
What to expect from your doctor
Be prepared to answer questions about your symptoms and your health, such as:
- When did you begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?